Clinical toxicology : the official journal of the American Academy of Clinical Toxicology and European Association of Poisons Centres and Clinical Toxicologists
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Clin Toxicol (Phila) · Sep 2013
Predicting the requirement for N-acetylcysteine in paracetamol poisoning from reported dose.
There is contention over whether reported dose correlates with toxicity in paracetamol poisoning and risk assessment is currently based on serum paracetamol concentration compared to a nomogram, irrespective of reported dose. Objective. To determine if reported dose predicts the need for N-acetylcysteine (NAC). ⋯ Reported dose was a good predictor of a toxic paracetamol concentration and SDAC reduced the probability of the concentration being above the nomogram. These predictions may assist in determining which patients could be started on NAC immediately.
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Clin Toxicol (Phila) · Sep 2013
Multicenter StudyDemographics and outcome of unintentional insulin overdoses managed by three poison centers.
Insulin dosing errors are one of the most dangerous medication issues due to the risk of profound hypoglycemia. The incidence of insulin dosing errors is increasing and there is no standard of care for management location. ⋯ Insulin dosing accidents can be routinely managed at home by PCs and have a low rate of hypoglycemia and adverse outcomes. This suggests that these cases can often be managed at home without referral with a potential benefit in no direct cost to the patient, convenience, and immediacy.
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Clin Toxicol (Phila) · Sep 2013
Pre-hospital management and outcome of acute poisonings by ambulances in Yekaterinburg, Russia.
Large, prospective pre-hospital studies of acute poisonings are scarce. We present the epidemiology of the pre-hospital poisonings, the treatment given, the complications of the poisoning itself and the treatment, predictors for hospitalization, and the safety of the present approach in a large industrial Russian city. ⋯ This study reveals current practice differing from the common treatment practice in most places, especially concerning the use of gastric lavage. Whether the current practice led to an increased morbidity and mortality is uncertain, but it justifies the need for thorough evaluation of clinical practice. These findings highlight the importance of studies like the present to improve diagnostics, triage, and treatment in acute poisonings.